Surgery-first approach in orthognathic surgery: Psychological and biological aspects – A prospective cohort study

Evaluation of Postoperative Mandibular Positional Changes After Mandibular Setback Surgery in a Surgery-First Approach: Isolated Mandibular Surgery Versus Bimaxillary Surgery

“…Because of the RAP, orthognathic surgery could enhance osteoclastic activities and metabolic changes in the dentoalveolar region for 3 to 4 months after surgery, which could accelerate orthodontic tooth movement during postoperative orthodontic treatment. 7,9,10 The SFA does not have greater technical complexity in surgical procedures than the OFA. 10,28 For postoperative outcomes including occlusion and quality of life, Yang et al 29 concluded that the SFA might be associated with similar outcomes compared with the OFA.…”

“…5,6 Without preoperative orthodontics, total treatment duration and patient discomfort can be considerably decreased, and postoperative tooth movement can be accelerated because of the regional acceleratory phenomenon (RAP). [7][8][9] In addition, patients are satisfied with the treatment because of the immediate improvement in facial profile, which can have a positive psychological impact on patients in the early stage of the treatment period. 9 For the patient selection for the SFA, several indications have been suggested: 1) good alignment of mildly crowded anterior teeth, 2) flat to mild curve of Spee, and 3) normal to mild proclination or retroclination of the incisor.…”

“…[7][8][9] In addition, patients are satisfied with the treatment because of the immediate improvement in facial profile, which can have a positive psychological impact on patients in the early stage of the treatment period. 9 For the patient selection for the SFA, several indications have been suggested: 1) good alignment of mildly crowded anterior teeth, 2) flat to mild curve of Spee, and 3) normal to mild proclination or retroclination of the incisor. 1,7,[10][11][12] Cases with severe crowding, vertical or transverse discrepancy, or asymmetries have been usually excluded from the SFA.…”

Introductory Chapter: Innovations in Orthodontics

“…In the beginning of the treatment, surgery is performed without orthodontic preparation, and the orthodontic treatment is applied after the surgery. With this approach, patients benefit with the early correction of facial esthetics and psychosocial outcomes of improved body image at the beginning of the treatment [11][12][13] instead of worsening the facial appearance because of the presurgical decompensation of incisors as it is done in contemporary orthognathic surgery [11,14].…”

Chirurgische Maßnahmen im Rahmen der kieferorthopädischen Behandlung

“…In den meisten Fällen erfolgt die dentale kieferorthopädische Korrektur zeitlich vor dem chirurgischen Eingriff. Abhängig vom Ausmaß der dentalen Fehlstellung und der skelettalen Dysgnathie kann im Sinne des "Surgery-first-Konzepts" auch erst die chirurgische Korrektur durchgeführt werden und anschließend die kieferorthopädische Therapie erfolgen Beide Verfahren bieten Vor-und Nachteile [1] Hier steht eine Anzeige.…”